Fecal incontinence is a loss of control over bowel movements resulting from the inability of the anal sphincter to retain feces.
Content
Anal sphincter insufficiency
A fairly common disease that can be caused by a number of reasons.
In domestic clinical practice, there are three degrees of insufficiency:
- 1st degree gas incontinence,
- 2nd degree incontinence of gases and liquid feces,
- 3rd degree incontinence of gases, liquid and solid feces, that is, complete incontinence of all types of intestinal contents.
Causes of the disease
Anal incontinence may result from
- damage or disease of the spinal cord,
- congenital diseases,
- damage to the rectum and anus.
The following factors also contribute to the disruption of this function:
- old age,
- extensive inflammatory processes,
- tumors
- damage during childbirth and operations,
- surgery for anal fissures .
Symptoms
The main symptom of anal incontinence is the inability to hold in feces.
If the disease is a consequence of inflammatory or tumor lesions of the anus, then along with the main symptom appear
- pain in the anus,
- bloody issues,
- other manifestations of the underlying disease.
Diagnostics
An objective examination consists of assessing the function of the anal sphincter. This assessment is performed either by digital rectal examination or by anal manometry.
Differential diagnosis
When making a diagnosis, it is necessary to conduct an examination for the presence of diseases that affect the rectal sphincter:
- tumors
- rectal fissures,
- paraproctitis.
Treatment
Treatment involves developing a program to manage bowel function.
By performing it, the patient must learn to have a planned bowel movement. The program includes adequate fluid intake and regular meals.
To facilitate bowel movements, suppositories with glycerin or bisacodyl, as well as enemas, are used.
If it is not possible to achieve regular bowel movements, then a low-fiber, low-fiber diet is prescribed. This diet includes meat and chicken broths, pureed meats and omelettes.
Imodium, which improves sphincter function, is often effective.
The patient is recommended to perform exercises that increase the muscle mass of the sphincter at the expense of the gluteal muscles. This is primarily a tension of the gluteal muscles with the sphincter retracting inward.
There are also surgical treatment methods based on sphincter plastic surgery.
- sphincteroplasty,
- sphincterolevatoplasty,
- sphincterogluteoplasty,
- plastic surgery using the adductor muscle of the thigh.
In particularly severe cases, indications for colostomy may be considered.
Forecast
The prognosis is favorable in most cases.
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